Seeking revision to DS...anticipating CIGNA issues

Hello ALL!

I had an RNY in 2000 and am just learning this past summer, via this board, that revisions are "a thing!" I  got insurance through my job this year because they had a plan that covered revisions.

My BMI is currently 44.9 and CIGNA requires a BMI of >50 for DS. I have lupus, arthritis, and systolic heart failure as my air co-morbidities.

The 64K questions is: Does that requirement mean for all DSers, or just first time DSers?

I have called the "1800 CIGNA" line 4 times now and the first three agents thought it meant only for first timers, were actually pretty confident of it and made a believer out of me. However, when I called today, another agent said no, it means for all bariatric patients. He had his manager to read over it and  the manager agrees. That stinks! There is room for ambiguity and a little confusion on the part of how the requirements are listed, I think.

Anyhoo, has anyone had any recent experience with battling CIGNA and how to proceed?

The guy today mentioned  a reauthorization and if it was denied to get the doctor to do a peer to peer call.  Do you think it is a BIG DEAL to ask for a peer to peer, or is it pretty common these days? Are there other things I should do first before requesting that?

I have an appointment with Dr. Ayoola (Frisco/Denton, TX) next Tuesday for an in initial consult and just want to know what to expect on my part and what to expect from his office and CIGNA.

All comments, suggestions, and advice are welcome!

Thanks so much!